Ticket for Outdoor Patient
| Ward No. 2 | U-PHC No. | Registration No. 01342 | Date 26/09/2018 |
| Token No | SM/18-19/6926 17/01/2019 | Serial | 006 Last Visit: 21/08/2019 |
| Patient Name | Mr. GOUR MOHAN CHATERJEE | Contact No | 9239315470 |
| Address | 11, JAGAMOHAN LAHIRI LANE SERAMPORE, CHATRA, SERAMPORE | Age | 73 YRS Male |
| Token For | Medicine, | Charge | Free |
| B.P | mmHg | Weight | 65 KG |
| Pulse Rate | / min | Height | cm BMI: inf |
| Diagnosis | |||